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HomeMy WebLinkAboutEND OF THE ROAD LT 2BOnsite File #041-033-31 Municipality of Anchorage On-Site Water and Wastewater Section - (907) 343-7904 Page 1 of 3 ON-SITE WASTEWATER INSPECTION REPORT Permit Number:. OSP211318 PID Number: 041-033-31 Dwelling: IRE Single Family (SF) ❑ with ADU [I Duplex (D) M Two Single Family Project: n New 1-0-1 Upgrade Name PAULA NICOLO ABSORPTION FIELD Site Address F] Deep Trench F1 Wide Trench [I Bed ound 10500 BLACKWOLF *ANCHORAGE,,AnK 99507 El Other Phone Number of Bedrooms Soil Rating Total depth original grade 954-662-6858 1 4 (5 BEDROOM TANK) GPD/SF Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade Gravel depth beneath pipe Subdivision Block Lot Depth to pipe in eft Lot END OF THE ROAD; LOT 2B Ft. Ft. Township Range Section Fill added above ori,inal gr Ft. JGravel length Ft. SEPARATION- -DISTANCES Gravel width Ft. Beds: Number of Lines Distance between lines Ft. TO Septic Absorption Lift Station Holding Sewer Total rption area Number of trenches Dist. between trenches From Tank Field Tank Line Ft2 Ft. Well 100'+ TANK 9 Septic I-] S.T.E.P. [Ell Holding 0 Other Manufacturer Capacity Surface Water 100'+ GREER TANK 1500 Gal. Material Number of compartments Lot Line 51+ NA HDPE 2 Foundation LIFT STATION Manufacturer Capacity Remarks OLD TANK DECOMMISSIONED PER UPC Gal. PER CONTRACTOR Alarm location Electrical installed by Tank to Installer PIPE MATERIAL House to tank D3034 drainfieldD3034 NORTHERN EXCAVATION Drainfield D3034/r=X1S'nNG CO/MT D3034 Inspector GEG AND MOA BENCH MARK (Assumed elevation) 100.00 ft Inspection is, 10/1/2021 Location and description dates: — 2 nd BOTTOM OF HOUSE TRIM AT FCO 3 rd 4"_ ON-SITE WATER AND WASTEWATER SECTION APPROVAL Engineer's Stamp Conditional Approval: Date . .................. ✓ ............... Septic System Approved CE-79.3 Date zozf Note: this approval does not include well permit requirements. 4�paP'ofessi000 #AECC884 (Rev 05102/18) PERMIT NUMBER: OSP211318 A B MH1 18.9 20.3 ST1 20.7 23.1 DBL1 22.0 25.0 DBL2 22.5 25.4 SWING TIES DERIVED FROM AS -BUILT SURVEY EXISTING DRAINFIELD PER MOA RECORDS AND PREVIOUS AS -BUILT / \ SURVEY; DRAINFIELD WAS "JETTED" PER CONVERSATIONS WITH / JOHN AT NORTHER EXCAVATION ON 10/22/21 / S / dQ / d. a EXISTING NEW 1500 GALLON 4v HOUSE HDPE GREER TANK \ q N SCALE: S 1"=40' PARCEL ID NUMBER: 041-033-31 .a e .. .d • d GRAVEL DRIVEWAY 4 d• .a i. •e ° 4' d a• •a .o e d . C) L100'WELLRADIUS IOF UARNESS EN(_l'lN'rff__`jERlN(J" GROUP, Ltd ... .. . •..................... 0 — ENGINEERING ,­� SALES � CONSULTING 3701 E. TUDOR ROAD, SUITE 101 • ANCHORAGE, AK 99507 • PHONE (907) 337-6179 • FAX (907) 336-3246 • WEBSITE: - gamewengi eenng com ,,,, y,,,,, , PREPARED FOR: PHONE NUMBER: PAGE NUMBER: 0- ��• • , 0 PAULA NICOLO 954-662-9858 2 OF 3 �j , ffrey A mess .'� LEGAL DESCRIPTION: DRAWN BY: •�/U CE -795 ••'� END OF THE ROAD; LOT 213 D.J.G. #� ��A"•�.......... . TYPE OF WORK: DATE: LICENSE /4` "'� ESS � SEPTIC TANK RECORD DRAWINGS 10/25/2021 #AECCe84 ltiavisks i P ERMIT NUMBER OSP211318 : RECORD DRAWING TOP OF MANHOLE = 99.75 FINAL GRADE = 99.49-99.55 MH1 TOP OF TANK AT INTLET = 93.86 --\ FM Im I I r-- TOP OF TANK AT OUTLET = 93.83 INVERT OF BUNG AT INLET = 93.21 NEW 1500 GALLON H.D.P.E. SEPTIC TANK PARCEL ID NUMBER: 041-033-31 INVERT OF BUNG AT OUTLET = 92.95 (_ff'ARNESS EN%4"ff INEERINGY ("ff ROUP, Ltd ENGINEERING � SALES - CONSULTING 3701 E. TUDOR ROAD, SUITE 101 *ANCHORAGE, AK99507' PHONE (907) 337 -6179 -FAX (907)338-3246 PREPARED FOR: PHONE NUMBER: PAGE NUMBER: PAULA NICOLO 945-662-9858 3 OF 3 LEGAL DESCRIPTION: DRAWN BY: END OF THE ROAD; LOT 213 D.J.G . TYPE OF WORK: DATE: � SEPTIC TANK PROFILE 10/22/2021 milt AV ...... ........................ ........... .. f7efffrey ' a ess 8yzo # CE- 953 4PAW # Air AV r......... s LICENSEO� " s\ #AECC884 l'vlIlkvAlk%*** /�� 50' DRIVEWAY , �• .0�� BLACKWOLF CIRCLE 15' T&E EASEMENT 5' SNOW STORAGE EASEMENT LOT 3 LOT 2A 1 Ni N 88041'00" E 159.98' \24 \ cT \ TRANSFORMER E SEPTIC STANDPIPES / / SEE " BUILDING / DETAIL (WD ASPHALT WELL Z CIOW L 5 O do P Z O CD O CD N Ccy) C 00 I Cil UNSUBDIVIDED EASEMENTS OF RECORD, OTHER THAN THOSE SHOWN ON THE RECORDED SUBDIVISION PLAT (2019-73) ARE NOT SHOWN HEREON. THIS DOCUMENT DOES NOT CONSTITUTE BOUNDARY SURVEY AND IS SUBJECT TO ANY INACCURACIES THATA SUBSEQUENT BOUNDARY SURVEY MAY DISCLOSE. UNDER NO CIRCUMSTANCES SHOULD ANY OF THE DATA HEREON BE USED FOR CONSTRUCTION OF FENCES, IMPROVEMENTS, OR FOR ESTABLISHING PROPERTY BOUNDARIES. Z9y 3 LOT 2B 7.54 ACRES N Lrl po in CONC. S 89°57'51" W 435.01' 0 50' 100' DRAINAGE WAY CD CD CD Cy) IQ m rn co CD O N c z c W v v m v BUILDING DETAIL S�ANo pFS 44,1 �yoLE 0 8. S• r OAU � N GQ3�O� O� c<"' x DECK? of \ 23.7 1S 0' 0 1.0, 2 -STORY FRAME BUILDING 1"=20' O 'Q. -. ..0',. ... c� G S, 8 S, CONCRETE' : ' ";;"..... 0 o N N 6.0, 0 MUNICIPALITY OF ANCHORAGE On -Site Water & Wastewater Program PO Box 196650 4700 Elmore Road Anchorage, Alaska 99519-6650 Phone: (907) 343-7904 Fax: (907) 343-7997 http://www.muni.org/onsite On -Site Wastewater Disposal System Permit Permit Number: OSP211318 Work Type: SepticTank Upgrade Tax Code Number: 04103331000 Site Legal Address: END OF THE ROAD LT 2B G:2143 Site Mailing Address: 10500 BLACKWOLF CIR, Anchorage Owner: NICOLO MATTHEW D Design Engineer: GARNESS ENGINEERING GROUP LTD This permit is for the construction of: Effective Date Expiration Date: Lot Size in Sq Ft Total Bedrooms: G <i Ws ]] C; Ia a I- till ell t 8/3/2021 8/3/2022 ❑ Disposal Field P Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage All construction shall be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (18AAC72) and Drinking Water Regulations (18AAC80) 3. The wastewater code requires inspections during the installation. The engineer shall notify the Development Services Department per AMC 15.65. Provide notification by calling (907) 343-7904 (24/7). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather shall be either: a. Opened and Closed on the same day, or b. Covered, sealed, and heated to prevent freezing Received By: Date: Q _ Issued By: Date: U 3.Z 11 Development Services Department \ Phone: 907-343-790. On -Site Water & Wastewater Section Fax: 907-343-7997 ON-SITE SEPTICMIELL PERMIT APPLICATION Parcel I.D. 041-033-31 Property owner(s) Paula Nicolo Mailing address 10500 Blackwolf *Anchorage, AK 99507 Site address 10500 Blackwolf *Anchorage, AK 99507 Legal description (Sub'd., Block & Lot) End of the Roard; Lot 213 Legal description (Township, Range & Section) Lot Size Day phone 954-662-9868 Sq. Ft. Number of Bedrooms 4 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (® all that apply) Absorption Field ❑ Initial ❑ Single Family (SF) (w/wo ADU) Septic Tank Q Upgrade (D) F-1❑ Holding Tank ❑ RenewalDuplex Multiple Dwellings ❑ Privy ❑ (SF and/or D) Private Well ❑ Water Storage ❑ THIS APPLICATION INCLUDES A WAIVER REQUEST FOR: (7(7AZ/1 C S S "l e .--i Distance: I certify that the above information is correct: further certify that this is in accordance with applicable Municipal Codes. (Signature of property owner or authorized agent) Permit/Rush Fees: Z Date of Payment: 713c) 20 Receipt Number: 097 R 1� G Permit No. D�P 21 131 g Waiver Fees: Date of Payment: Receipt Number: Waiver No. GADevelopment Services\Building Safety\On Site Water and WastewaterTormsUient FormsTermit Application.doc Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP211318, Rebecca Carroll, 08/03/21 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP211318, Rebecca Carroll, 08/03/21 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP211318, Rebecca Carroll, 08/03/21 BUILDING DETAII 0• a] : �WA I mom A� c IN I % tK 74 ol 3304� �?,\ 6' NO. 2 -STORY FRAME BUILDING 'OF I I I /I I I I I I I 1 .0, _ 'fIf!!lIJlllrlfl�1 !Y!!rr}lPlrllfflxJl ✓tFI/ C-ONC R.ETE'..' 11 1 1 OF I I I 1 .1 1 -e I 1 11 11 11 / I I I ; I I z y cv % 01.1 IF 6fYJr//!f#/f/f/fIr/!/ 01 OF IF S 89057'51 W 435.011 OF UNSUBDIVIDED zi ............ ...... .. EASEMENTS OF RECORD, OTHER THAN THOSE SHOWN ON THE J0 00 RECORDED SUBDIVISION PLAT (2019-73) ARE NOT SHOWN HEREON. 40, 0 50 00, uk-u Sa THIS DOCUMENT DOES NOT CONSTITUTE A BOUNDARY SURVEY AND 1 L IS SUBJECT TO ANY INACCURACIES THAT A SUBSEQUENT BOUNDARY '-1483'7 <1 �- C3 SURVEY MAY DISCLOSE. fit -, UNDER NO CIRCUMSTANCES SHOULD ANY OF THE DATA HEREON BE of-ESSIOW USED FOR CONSTRUCTION OF FENCES, IMPROVEMENTS, OR FOR ESTABLISHING PROPERTY BOUNDARIES. 1.00, .100" 0.00, 0• a] : �WA I mom A� c IN I % tK 74 ol 3304� �?,\ 6' NO. 2 -STORY FRAME BUILDING 'OF I I I /I I I I I I I 1 .0, _ 'fIf!!lIJlllrlfl�1 !Y!!rr}lPlrllfflxJl ✓tFI/ C-ONC R.ETE'..' 11 1 1 OF I I I 1 .1 1 -e I 1 11 11 11 / I I I ; I I z y cv % 01.1 IF 6fYJr//!f#/f/f/fIr/!/ 01 OF IF S 89057'51 W 435.011 OF UNSUBDIVIDED zi ............ ...... .. EASEMENTS OF RECORD, OTHER THAN THOSE SHOWN ON THE J0 00 RECORDED SUBDIVISION PLAT (2019-73) ARE NOT SHOWN HEREON. 40, 0 50 00, uk-u Sa THIS DOCUMENT DOES NOT CONSTITUTE A BOUNDARY SURVEY AND 1 L IS SUBJECT TO ANY INACCURACIES THAT A SUBSEQUENT BOUNDARY '-1483'7 <1 �- C3 SURVEY MAY DISCLOSE. fit -, UNDER NO CIRCUMSTANCES SHOULD ANY OF THE DATA HEREON BE of-ESSIOW USED FOR CONSTRUCTION OF FENCES, IMPROVEMENTS, OR FOR ESTABLISHING PROPERTY BOUNDARIES. -i 0 724310 7 4 2 p.1 MUNICIPALITYOF ANCHORAG11 Developr,nenj Services Depa,-tmen On -Site 'Afater& t Wasis'Aeater SectionIMPhone: 907-343-7904 P Fax: 907-343-7997 Well Driningr. Pump Installation Log ParO'A Identification Nurtiber: DXtq of Issue: ji _31 Legal I)eseription Block !Let -?"Opeftv ONVRe NRme 41L, Address:' 2- PD Pump on I s"UIQP intake Depth Bejoyv, I'O-P (If Weilcas�glg. J�Nb feet PL,I,np INI-anufacturcr's Name: PU E71 P M 0 d e 1: _Z PUDIP Size: _hn, Pitts Adapter Bark ai Epeptt:: PjOesl -adapter P162ss Adapter 1mtaJkr: WIA Disilifected Upul, 0 oil I -NfethOd -PUMP hAader Nam,( A!"' C H 0 RA G E ?6410 J(irj:, Strut & "UMPSERVICF Et Anchorage. AK 99s ­_s 11,211ing Address: P'4; (90_7,243-040 ?gates ------ =40-71p: Aftenrlow The pur.,jp ills t,jj I a, sj, a!, &.Pump - "10?1109 tc On -she within- ,Gays of Ptmr .P Municipality of Anchorageo.'~'~.,: Development Services Department :',~'",~3' Building Safety Division On-Sile Water and Wastewater Program, 4700 S. Bragaw SL P.O. Box 196650 Anchorage. AK 99519-6650 Page 1 o[ ~.ci.anchorage.ak.us (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Permit Number: SN0001 74 PID Number:- ~¢7~, "'~': Roger Cremo Wastewater System: ~ New ~ Upgrade P.O. ~ox 210347 Anch, AK 99521 ABSORPTION FIELD 333-8188 4 ~DeepTren~ DShall~Tren~ ~Be4 DMound Sol1Rsllng: Total Deplh gem original gr~e: LEGAL DESCRIPTION 1 . 2 GPDIFIt 12 . 0 Ft, Home Tract Hillside North ~8 6.0 F,. 6.0 ,~. 1 . 4 ~. 4 9 · 5 ~'. Well: ~ New ~ Upgrade 3.0 F,. 1~ N/A ,,. Private 155 ,,. 66 ~,. 594 F~' PVC (D3034) Alpine Drilling 6-16-00 42 F,. ;roeneweo Conskr. 7-1a-nn 6 s~ ot instal~ 2' ~,. TANK SEPARATION DISTANCES ~sepuc U HoUi.g SS.T.E.P. U Tank ~ie~d Sta[]o~ Ta~k SewerUne Anchorage Tank 1250 Meteri~: Number of Companmenls: Su~a~wa,e, > 100 'l >100' N/A N/A ~/ size: Manu[acturer:LIFT STATION ""~"~': BENCH MARK Bouse hoe co~st~uc[ed at [~me o[ survey. ~op o[ 6" steel ~ell casino 1353.54F~. Engineer's Stamp Inspections pe~ormed by: DHI Consulking Dates: 1't 7-13-00 ~*~4~ ~/ Engineers 2"~ 7-14-00 Development Se~ices Department Approval . D,~ ' Per.mlf No. SW000174 Municipality of Anchorage Department of Health and Human Services ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 ® Anchorage, AK 99519-6650 · Tel: 34,3-4744 On-Site Wastewater Disposal System/Well Legol Description: HILLSODE NORTH ADDN. iii8 HOMI~ TRACT Pcge 2 of. '7 W.O. 98550 Dcfle 7/17/01 Inspection Report PID No. 014-005-21 SYSTEM DESIGN CALCULATIONS 1. NO. BEDROOMS = 4 2. DEEP TRENCH SYSTEM 5. SOIL RATING : 1.2 GAL/DAY/SF 4. DEPTH OF GRAVEL = 6' 5, ACTUAL LENGTH OF TRENCH = 49.5' 6. REQUIRED ABSORBTION AREA = 500 SF 7. ACTUAL ABSORPTION AREA = 594 SF Permit No.. SWO00174 Municipality of Anchorage Department of Health and Human Services ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 · Anchorage, AK 99519-6650 · Tel: 343-4744 Well & On-Site Wastewater Disposal System Legal Description: Page 3 of 7 W.O. 98550 Date 7/17/01 HILLSIDE NORTH ADDN. ~8 HOME TRACT PID No. 014-005-21 ~LOT LOT 1 S15'33'25"E LOT 4 LOT 4 BLOCK 5 LOT 5 LBT 3 BLDCK 5 LOT 5 LOT 6 ~- N 69'30'08" E EASEMENT N29'O7'22"E 510 S25'29'52"E ~----.-CREEK EASEMENT EASEMENT '-' z PROPOSED n0 HOUSE / (NOT CONSTRUCTED) N895T44"E 1591.52 RECORD DRAWING sc^LE: ,"= 400' Permit No. SW000174 Municipality of Anchorage Department of Health and Human Services ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 * Anchorage, AK 99519-8650' Tel: 343-4744 Well & On-Site Wastewater Disposal System Legal Description: HILLSIDE NORTH ADDN. ~8 HOME TRACT PlO No. Page 4 of ? W.O. 98350 Date 7/17/01 014-005-2' ,t=TOP OF WELL ELEV.=1353.34 FOUNDATION C.O. TANK PUMP OUT TANK PUMP OUT OPPOSING C.O. OPPOSING C.O. INTERMIDATE C.O FIELD C.O. FIELD C.O. RECORD DRAWING SCALE: 1" = 100' CE DATE Permit No. bWUUU I ! 4. Municipality of Anchorage Department of Health and Human Services ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 * Anchorage, AK 99519-6650* Tel: 343-4744 Proposed Well & On-Site Wastewater Legal Description: HILLSIDE NORTH ADDN. ~8 HOME TRACT Disposal Page U of '( W.O. 98350 Date 7/17/01 System PID No. 014-005-21 10.0' FOUNDATION 4" PVC PIPE 1332.0 ~ALL ELEVATIONS ARE TO INVERT OF PIPE UNLESS OTHERWISE NOTED -- 11331.8 INV. 1250 GAL SEPTIC TANK 4" PERF. PVC :.0 GRADE ~ OF TRENCH INV. .EAN OUT END OF t~E~'C~---- PROFILE SCALE: NT$ Permif No. SWO00174 Municipality of Anchorage Department of Health and Human Services ENVIRONMENTAL SERVICES DMSION Page § of ? W.O. 98550 Date 7/17/01 P.O. Box 196650 * Anchorage, ti{ 99519-6650' Tel: 343-4744 Proposed Well & On-Site Wastewater Disposal System Legal Description: HILLSIDE NORTH ADDN. ~8 HOME TRACT PID No. 014-003-21 ORGANIC SILT, DrY BROWN SLIGHTLY SILTY SANDY GRAVEL, OCCASIONAL ROCK TO 15" DRY 2.0 ORIGINAL GROUND MATERIAL ,,,//,~-FINISH GRADE // 13,02.5 __ NATIVE FABRIC PERFORATED PFC PIPE 1294.9 JGHT TO MEDIUM SAND W/ GRAVEL r TO SEASONAL HIGH B.O.T. NO WATER TABLE '~-AT~ --- '~'/~"~'~ ~'~/~'~'/'~'~'~)"/~ -TO BEDROCK OR IMPERMEABLE LAYER ROCK INSTALLED PER M.O.A. SPECIFICATIONS Permlf' No. SW000174 DHI CONSULTING ENGINEERS Legal Degcrlpflon: HILLSIDE NORTH ADDN. 8 HOME TRACT NOTES: Page. 7 of 7 W.O. 98550 Date 7/17\01 CONSTRUCTION WAS COMPLETED IN ACCORDANCE NTH CHAPTER 15.65. WASTEWATER DISPOSAL REGULATIONS. iNSTALLED A 2 COMPARTMENT, 1250 GAL. STEEL SEP~C TANK. ALL PiPE IS PVC CONFORMING TO ASTM D3034. CLEANOUTS HAVE BEEN INSTALLED AT THE ENDS OF THE TRENCH AND A 4" MONITORING TUBE WAS INSTALLED NEAR THE END OF THE TRENCH. $50SSD1D ~ rage Department of Health and Human Services 825 'L' ~treet P.O. Box 19~650 Aocimr~e, Alaska 99519-6650 Rick Mystro~1 ht¥:/Ne~v.cl.a~h~'age.ak.us Mayor Property Owaer Name & Address: Roger Creme PO Box 21034? Anchota~ ~4k-995 2 J- Borehole Data: Depth (fl) Soil Ty~, 'l~idmess & Water Strata From To st~k-op 0 2 sil~ gm~l 2 54 ' B~ ~ 167 H20 'lOg f ~3 H20 1,~0 155 Method of Driillng [] air tatar7 [] cable (ool Casing type: steel Wall Thickness: .025 inches Diameter: _6 inches Depth: 66 feet Liner Type: __ Diameter: __ incah_cs Depth:, Casing stlckup above groand: _2 feet .... feet Static water level (~om ground level): 42 feet Pumping level: 167 feet aRef _2 hours pun~ping _6 gpm Reeovery Rate: 6 gpm Method of Te~ting: airlift. Well Intake Openiag Type: [] Open End [] Open l[ole [] Screened ~tsrt feet Stop~l ._-- [] Perforations Start feet Stopped__ feet feet Grout Type: Bentonite ~ 8 Volume: I bg Depth: Start _0 feet Stopped ~ f~t Pump: Intake Depth __ feet Pump size hp Brand Name Well Disinfected Upon Completion? [] Yes [] No Method ofDisiufection: Ctorine Tpbtuts Comments: Well Ddller: Alpine Drilling & Eoteiprises P O Box ~0496 Anchorage AK 995ff Atte~ioa: The well driller sl~all provide a well log to the property owner within 30 days of completion and tho property 06-29-2~0 11: 35PYl 33B BO41 P. 01 MUNICIPALITY OF ANCHORA GE Department of Health and Human Services On-Site Services Program 825 L Street, Room 502 P.O. Box 196650, Anchorage, AK 99519-6650 (gO7) 343-4744 Date Issued: Jun 16, 2000 Expiretion Date: Jun 16, 2001 Permit N umber: SW000174 Legal Description: HILLSIDE'NORTH #8 HOME TRACT ~ Design Engineer: 0060 DHI Engineering Owner Name: Roger Cremo Owner Address: PO Box 210347 Total Bedrooms: 4 Anchorage, AK 99521- Parcel ID: 041-033-21 Site Address: Lot Size: 1797286 SQ. FT. Permit Bedrooms: 4 This permit is for the construction of: [] Disposal Field [] Septic Tank [] Holding Tank [] Privy [] Private Well [] Water Storage All construction must be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal Code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations ( 18AAC72 ) and Drinking Water Regulations ( 18AAC80 ). 3. The engineer must notify DHHS at least 2 hours prior to each inspection. Provide notification by calling (907) 343-4744 ( 24 hours ). ( Not required for a Water Supply Permit only ). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must be either: A. Open and closed on the same day. B. Covered, sealed, and heated to prevent freezing. Received By~~,~~ Date: Pea-mit ~o. ' Municipality of Anchorage Department of Health and Human Services ENVIRONMENTAL SERVICES DWISION P.O. Box Well & Legal Description: 196650 ° Anchorage, AK 99519-6650 * Tel: 343-4744 On-Site astewater Disposal System HILLSIDE NORTH ADDN. #8 HOME TRACT PID No. Page ! of 5 W.O. 98550 Date 5/51/00 LDT LDT I S15'33'25"E 128: N29'oT22"E S25'29'52"E 219..~ LBT 3 BLDCK 5 LOT ¢ LDT 4 BLOCK 5 LOT 5 LOT 6 LOT 5 N 69'30'08" E ,~ "5' EASEMENT ~---T&E EASEMENT PROPOSED HOUSE N89'sT44"E 1591,52 EASEMENT LEACH FEILD SCALE: 1" = 400' 'fi-IlS PROdECT .~ED WELL Permlf No Municipality of Anchorage Department of Health and Human Services ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 * Anchorage, AK 99519-6650' Tel: 343-4744 On-Site Wastewater Disposal System/Well Inspection Legal Description: HILLSODE NORTH ADDN. #8 HOME TRACT PlO No. Page 2 of 5 W.O. 98350 Dale 5/31/00 Report SYSTEM DESIGN CALCULATIONS 1. NO. BEDROOMS = 4 2. USE TRENCH SYSTEM 5. ABSORBTION AREA = (# BEDROOMS)(150 GPD/BR) TRENCH APPLICATION RATE = (4)(lSO) : soo SF 1,2' TRENCH AREA = (2)(DEPTH OF GRAVEL)(LENGTH) = 500 SF IF DEPTH OF GRAVEL = 7' THEN LENGTH OF TRENCH = 36' *[ PERCOLATION RATE MIN/INCH 0-1 1-5 6-15 ....... 16-50 ,51-60 GREATER THAN 60 FILTER LAYER PIT & TRENCH APPLICATION RATE GPD/SF NOT SUITABLE 1,2 O.B 0.45 NOT SUITABLE 1,0 MOUND & BED APPLICATION RATE GPD/SF NOT SUITABLE 0,8 0,4 0.5 NOT SUITABLE .7 ' Permit No. ? Municipality of Anchorage Department of Health and Human Services ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 * Anchorage, AK 99519-6650 * Tel: 343-4744 Well & On-Site Wastewater Disposal System Legal Description: HILLSIDE NOi~TH ADDN. f~8 HOME TRACT PID No. Page 3 of 5 W.O. 98550 Dale 5/31/00 s¥~ / / ./ ;lNG ~AL. ; ~EE r~OTE CE SCALE: 1" = 100' DATE ,,,e. Per, mit No. Legal Description: Dill CONSULTING ENGINEERS HILLSIDE NORTH ADDN. 8 HOME TRACT NOTES: Page 4 DJ 5 W.O. 98350 Date 5/31/00 1 2 4 5 6 7 9 10 11 12 15 14 15 16 17 ALL CONSTRUCTION SHALL BE IN ACCORDANCE WITH CHAPTER 15.65, WASTEWATER DISPOSAL REGULATIONS OF Tile MUNICIPAL CODE, AND MOA STANDARD SPECIFICATIONS FOR STREETS, DRAINAGE, UTILITIES AND PARKS (MASS) 1994 AS CURRENTLY AMENDED, AND ALL APPLICABLE STATE AND FEDERAL REGULATIONS. , INSTALL 2 COMPARTMENT, 1250 GAL. STEEL SEPTIC TANK. SET TANK LEVEL. EXISTING STRUCTURES, WELLS, SEPTIC SYSTEMS OBSERVED WITHIN 200 FT. OF THE PROPOSED SYSTEM SITE ARE SHOWN ON DESIGN DRAWINGS. ANY DEWATION FROM THE DESIGN MUST BE AUTHORIZED BY THE ENGINEER PRIOR TO ITS INCORPORATION INTO THE SYSTEM. CONTRACTOR TO STAKE PROPOSED SYSTEM &: NOTIFY THE ENGINEER OF ANY OBSERVED CONFLICTS PRIOR TO CONSTRUCTION. STAKE LOCATION OF EACH END OF TRENCH, NOTE DEPTH OF CUT ON LATH. CONTRACTOR SHALL HAVE SURVEY LEVEL AND ROD SET UP ON SITE DURING CONSTRUCTION. CONTRACTOR TO NOTIFY THE ENGINEER AND DHHS 24 HOURS PRIOR TO COMMENCING WITH CONSTRUCTION. A MINIMUM OF THREE SITE VISITS ARE REQUIRED. THE FIRST VISIT SHALL BE OF THE SUBGRADE PRIOR TO PLACING THE SEWER ROCK. ]'HE SECOND VISIT SHALL BE AFTER THE PLACEMENT OF SEWER ROCK, DISTRIBUTION PIPING, STANDPIPES, AND OTHER COMPONENTS AS SPECIFIED. THE THIRD VISIT SltALL BE AFTER TNE WORK IS COMPLETED. CONTRACTOR SHALL DELIVER TO THE ENGINEER A SET OF RED-LINED, AS-BUILT DRAWINGS SHOWING ALL DATA AS SPECIFIED IN SEC. 15,65.F. 2, .3, 4, 5, 6 OF MUNICIPAL WASTEWATER DISPOSAL CODE WITHIN FIVE DAYS OF THE FINAL VISIT. INVERTS AND SWING TIE LOCATES SHALL BE TO THE NEAREST TENTH OF A FOOT. THESE AS-BUILTS SHALL BE USED BY THE ENGINEER TO PREPARE AND SUBMIT RECORD DRAWINGS TO DHHS. ALL EXCAVATION DEPTHS ARE ADVISORY. THEY ARE TO BE VERIFIED AND MAY BE MODIFIED BY THE ENGINEER IF ACTUAL FIELD CONDITIONS VARY FROM THOSE USED TO PREPARE THE DESIGN. BOTTOM OF TRENCH EXCAVATION SHALL BE LEVEL. SIDEWALLS SHALL BE SCARIFIED. RECORD ELEVATIONS AT BEGINNING, MIDDLE, AND END OF TRENCH BOTTOM. PLACE THE SEWER ROCK TO THE SPECIFIED DEPTHS. DO NOT CONTAMINATE SEWER ROCK. LEVEL ROCK SURFACE TO ± 0.1' PRIOR TO INSTALLING THE PERFORATED PIPE. ALL. PIPE SHALL BE PVC CONFORMING TO ASTM D3034. ALL JOINTS SHALL BE SEALED WITH APPROVED GLUE. CLEANOUTS SHALL BE INSTALLED AT THE END(S) OF THE TRENCH(S). 4" MONITORING TUBE(S) SHALL BE INSTALLED AT THE END OF EACH TRENCH, WHERE SHOWN ON PLANS. COVER THE DISTRIBUTION PIPE WITH MIN 2" SEWER ROCK, BEFORE PLACING INSULATION AND/OR GEOTEXTILE, FILL, AND TOPSOIL. MINIMUM SOIL COVER SHALL BE 4 FEET OVER THE PIPE AND 4 FEET OVER THE SEPTIC TANK. ONE INCH OF INSULATION MAY BE SUBSTITUTED FOR 1 FOOT OF SOIL COVER, BUT THERE MUST BE A MINIMUM OF 2' OF SOIL COVER OVER THE INSULATION. ALL INSULATION BOARD SHALL BE 2" THICK POLYSTYRENE, DOW HI-35 OR ENGINEER-APPROVED EQUAL. CENTER BOARD WIDTH OVER PIPE. AN APPROVED GEOTEXTILE FABRIC SHALL BE INSTALLED BETWEEN Tile SEWER ROCK AND THE BACKFILL. MATERIAL USED AS FILL SHALL BE CLEAN AND FREE OF ORGANICS, TRASH AND CONSTRUCTION DEBRIS, SLORE ALL FILL MATERIAL AND TOPSOIL TO DRAIN AT 2% MIN. SLOPE, AND IN SUCH A MANNER THAT PONDING AT OR NEAR THE DRAIN FIELD DOES NOT OCCUR. Tile FILL SHALL BE LEFT 6" HIGHER THAN SHOWN TO ALLOW FOR SETTLEMENT. THE TOP 4" OF COVER SHALL BE TOPSOIL. SEED SURFACE AFTER COMPLETING INSTALLATION AS PER MUNICIPAL SPECS. CONTRACTOR TO BE RESPONSIBLE FOR THE REMOVAL AND DISPOSAL OF CONTAMINATED MATERIAL FROM THE ..... EXISTING TRENCHES, IF ENCOUNTERED. 350SSD1D Mon Jun 05 ~8:28:59 2000 Permif No. Proposed Well & On-Site Wastewater Legal Description: HILLSIDE NORTIt ADDN. #8 HOME TRACT Municipality of Anchorage Department of Health and Human Services ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 ® Anchorage, AK 99519-6650' Tel: 343-4744 Disposal Page 5 of 5 W.O. 98550 Date 5/51/00 System PID No. TH#I ORGANIC SILT, DRY ~IGINAL GROUND W/ NATIVE MATERIAL, SEE NOTE FABRIC PERFORATED PIPE BROWN SLIGHTLY SILTY SANDY GRAVEL. OCCASIONAL ROCK TO 15" DRY ROCK PER M.O.A. SPECIFICATIONS 2.0 I~]H~- TO MEDIUM W/ GRAVEL B.O.T. NO WATER TABLE TRENCH SECTION SCALE: NTS r TO SEASONAL HIGH WATER LEVEL BEDROCK OR IMPERMEABLE LAYER DATE DEPARTMENT OF HEALTH & HUMAN SER~ICES TEST HOLE 1 I ~ ~ ORGANIC SILT, DRY ( / / SLOPE Sl~ PLAN / // /. 2~/ 5 / /F /// ~ BRO~ SLIGHTLY SILTY ; 8 / / ~ DRY >.2/ 9 /// 10 ~/ / WAS GROUND WATER S - ENCOUN~RED ? NONE L ~/ /~ OI ~/// 11 IF ~S, AT WHAT p / / / DEP~ ~ · 'E ~2 DEP~ OF / ~./ AFaR MONITORIN~ ~ NONE DATE: 5/15/oo ( / / ~ ~0118/0~ ~:I7 ~" ~" 4.8 / / '/ / /~ 16 ~ , 17 = '~ FINE TO MEDIUM /- SAND W/ CRAWL, DRY ~ j · .. ~ BOT 18 PERCOLA~ON RA~: 4,8 (MINU~S/~NCH,) PERCHOLE DIAME~R: 6" ~ST RUN BE~EN: 3,0 FT. AND COMMEN~ET 4" P~F. PIPE (BOSOM SET ABOUT 2' ABO~ BOSOM OF PIT), PRE SOAKED SOILS BEFORE RUNNING ~ST, ALL ~E WA~R DRAINED IN LESS THAN 30 NlM, PERFORMED BY: OHI C~SUL~NG EN~. CER~FY ~AT ~IS ~ST ~AS PERFORMED IN ACCORDANCE ALL STA~ AND MUNICIPAL ~UIDELINES IN EFFECT ON ~15 DA~, DA~t * 550CAP1D ,.~m Jun ~)5 iii: ,]8:09 2060 MUNICIPALITY OF ANCHORAGE Development Services Department Phone: 907-343-7904 On -Site Water &Wastewater Section Fax:.907-343-7997 Certificate. of On -Site Systems Approval Parcel I.D. 041-033-24. ' Expiration Date:Z- 1. GENERAL INFORMATION E d ,Complete legal description End Of The. Road, Lot 2 Location(site address) .10500 BIackwolf Cirde Current property owners) Ghislaine Cremo . Caroline Renner,POfA Day phone .907-242-4552 Mailing address PO Box 210347, Anchorage, AK 99521 Real estate agent -Day. phone 2.. TYPE OF DWELLING:. 0 , Single Family (w/wo ADU) El Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3.. NUMBER OF BEDROOMS: 4 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER. DISPOSAL: Private Well Q Private Septic 0 . • Water.S.torage ❑ Holding Tank ❑ .. Community Well ❑ Community ❑ Public Water System' ❑ Public Sewer ❑ Waiver request for: Distance: Received by: Date: COSA to be released to the engineer, unless:otherwise requested by the engineer. COSA Fee $ 5 -JN �t� Waiver Fee $ Date of Payment 1 l l Date of Payment Receipt Number 01 MCI. Receipt Number COSA # �S l� ��. I Waiver # -ePlar� 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional. and adequatefor the number of bedrooms and type of structure indicated herein. I further vedfy.that based on the information obtained from the Municipality. of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system_ is (are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm Crewdson Engineering, LLC Phone 907-280-9493 Address PO Box 671389, -Chugiak, AK 99567 .Engineer's Printed Name James Crewdson Date i*• ..... ... .:� 6. DSD SIGNATURE •.�Ipr. System #1 Approved for bedrooms .'•.•�A i System #2'Approved for bedrooms 1 PROFESS��`—r . Disapproved A LLC .i 13a Conditional approval for bedrooms, with the following stipulations: 0((((QW(((�� . JJJJ< J Original Certificate Date: The Municipality of Anchorage Development services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. i i 7. ATTACHMENTS:. ...... COSA Checklist X . Nitrate Advisory ... ; ..... Septic System Advisory Arsenic Advisory i Legal Description: End Of The Road, Lot 2 If more than 1 septic system on lot: COSA Checklist # of A. WELL DATA OR Well log is filed with Onsite (or attached) Date drilled 6776/2000 Total depth 155 ft Cased to 66 ft ❑ Sanitary seal is functioning correctly ❑ Wires are properly protected Casing height (above ground) 18+ in. Date of flow test for COSA 10r3/2019 Static water level at beginning of test 60 ft. Comments B. TANK DATA . Age .of tank(s) 21 years Tank type/material steel ❑ Standpipes/foundation cleanout per record drawing Date of pumping 4-9-2021 Measured operating fluid level in septic tank: 49" D. ABSORPTION FIELD DATA Which system tested (date installed) 7/'4'2000 ❑ ALL standpipes present per record drawing Total measured depth from grade 13.2 ft (max) Measured depth to pipe invert from grade 7.2 ft (min) ❑ N/A — pressurized field ❑ Monitor tubes go to bottom of drainfield. If not, state depth into effective ❑ Code -required soil cover over field ❑ System presoaked (Required if vacant for greater than 30 days prior to date of test) Gallons introduced gallons Comments/Deficiencies: COSA Checklist yellow sheet Parcel ID: 041-033-24 Structure served by this system Well production at time of test 2.8 gpm Water storage tank volume none gallons Well disinfected for coliform test? ❑ Yes ❑ No ® Coliform bacteria is Negative Nitrate 0.4 mg/L ❑ Nitrate less than MRL (ND) Arsenic ug/L ® Arsenic less than MRL (ND) Collected by Crewdson Engineerinq Date of Sample 3-29-21 C. LIFT STATION [].Required maintenance completed Age of lift station years Lift station material Comments: Adequacy test date 1013/2019 Results ❑✓ Pass. For, 4 bedrooms Fluid depth prior to test 0 in Water added -600+ gal New depth 4 in Elapsed time 90 min Final fluid depth 0 in Absorption rate 600+ gpd Any rejuvenation treatment (past 12 months) If yes, enter date E. SEPARATION DISTANCES From Private Well on Lotto: (Please enter distances if less than required or if community well) Septic Tank/Lift Station on Lot > 100' F,(� Yes if No Community Sewer Manhole/Cleanout > 100' Yes if No ft Yes if No ft Neighboring Tank > 100' ®Yes if No ft Private Sewer/Septic Line > 25' QYes if No ft Absorption Field on Lot > 100' ❑✓ Yes if No ft Holding Tank > 100' ✓(Yes if No ft Neighboring Absorption Fields > 100' Water Service Line > 10' 0 Yes Animal Containment > 50'✓[] Yes if No ft 0 Yes if No ft Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' FV� Yes if No ft F%/ Yes if No ft From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10' F,(� Yes if No ft Surface Water > 100' Property Line > 5' [✓ Yes if No ft Driveway/Parking > 0' Absorption Field > 5' 0 Yes if No ft Wells on Adjacent Lots: Water Main > 10' [✓] Yes if No ft Private Wells > 100' Water Service Line > 10' 0 Yes if No ft Community Wells > 200' From Absorption Field on Lot to: (Please enter distances if less than required) Building Foundation >10' [f,/ Yes if No ft Driveway/Parking ?10' Property Line > 10' Yes if No ft Wells on Adjacent Lots: Water Main > 10' [71 Yes if No ft Private Wells > 100' Water Service Line > 10' M Yes if No ft Community Wells > 200' Surface Water > 100'[]✓ Yes if No ft F. ENGINEER'S COMMENTS [❑✓ Yes if No ft Yes if No, comment F, Yes if No ft WlYes if No ft Q Yes if No, comment []✓ Yes if No ft Yes if No ft G. ENGINEER'S CERTIFICATION Aso f �: •,� � 1 certify that I have determined through field inspections and review TH ......... t .. of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. %ewdson; r �T1527'.�+. / 1.�9n'l�lt��l•:'G Aw COSA Checklist yellow sheet t t q`tOFESSIO�P®`® GLC l t �a� Septic 'Tank Advisory Certificate of On -Site Systems Approval #OSC osc191491 Subdivision: Starting at 20 years of age the MOA issues Advisory's for steel septic tanks. The septic tank for this property is 21 years old. Typical replacement costs range from $8,000 to $11,000 This advisory must be attached to all copies of the subject Certificate of On -Site Systems Approval. This is an example of what the metal of a 20 -year-old steel tank MAY look like. LEGEND 20' T&E EASEMENT N 1 .2 S 30'2 '55.568" W i 1tW:;C2 S 09'45'11' E 21.04 / ss �s 49" E 13122: = N 8d' 14 LF CLE LOT 3 RECORD CURVE TABLE CURVE&200�2496.01 GTH CENTRAL ANGLE TANGENT CHORD CHORD BEAR. C1 14 41'24'55" 18.90 35,36IN 59'32'32" E C2 8 68'51'02" 34.27 56.531N 73'15'45" E C3 53 44'09'18" 20.28 37.59 5 50'14'05" E C4113'00'20" . C5 1 27'28'19" 48.95C6 75 97'51'49" 189.97 249.61 N 67'29'00" W �i n 2 S88'4l'OO'W GRAVEL PAD CD ^N I,, z 54p. In 4 0 D v m \ •�'• DRNNAGE WAY :IE \�� \ \ N 6V34'i0' W/ 0 D J •B, 20' ELECTRIC EASEMENT <c1 1 f \\ \ IC SEPTTPIPES 4 \\ \ SE IC / 11'].54 \\ /y a� /o � Js 2-SrORY MASONRY BLOCK/ W000 -FRAME HOUSE (SEE DETAIL) (I 152.93 Z m a O £ \ GRAVEL DRIVEWAY GO 0 /\ 3 DRAINAGE N 89'58'30" E 435.01 �I CHUGACH STATE PARK 52'26'02' W 103.]1 i'x2' CONCI 2ND STORY Vx HOUSE DETAIL SURVEYOR'S CERTIFICATION I, Dee FLgh. a Registered Profead-d Leod Surveyor, do hereby eertUy that auney of the oproperty deacrlbed hereon has bean ppeerformed b7 me r mder m7 di -.t MperviMon: d Ibet ezisUvg Improvameab visible et thne of tbie —T ere shown h¢eon. IL V the oapovslbWty at the ower to QeteraUae the e�atevo f my eesemmta, eovenenIs. or rcatricUom. Und¢ vo ircum t-- should my dela h¢eov be ad for comtrocUou or for aateblishivg fence or bounds Unna. �p,�F, OFACAs � ¢� i�yi� {1 • T "'� i .... 'E ve„” r �i^ a1i t•4•., Ls-ssef 44'; LSSLtUL�.� D—: 9 _3_ 19 60 0 60 120 180 1 1 1 1 1 1 I I I Did—. are shown iv feel �I PROPERTY LINE ---- ADJACENT PROPERTY LINE () RECORD INFORMATION PER PLAT NO. 2010-035 ® FOUND 5/8" REBAR ® FOUND 3 1/2" BRASS CAP MONUMENT ® WELL © ELECTRIC PEDESTAL O TELEPHONE PEDESTAL o SEPTIC PIPE 18" CULVERT GRAVEL DRIVEWAY/ROAD I, A,", nll r. 20' T&E EASEMENT N 1 .2 S 30'2 '55.568" W i 1tW:;C2 S 09'45'11' E 21.04 / ss �s 49" E 13122: = N 8d' 14 LF CLE LOT 3 RECORD CURVE TABLE CURVE&200�2496.01 GTH CENTRAL ANGLE TANGENT CHORD CHORD BEAR. C1 14 41'24'55" 18.90 35,36IN 59'32'32" E C2 8 68'51'02" 34.27 56.531N 73'15'45" E C3 53 44'09'18" 20.28 37.59 5 50'14'05" E C4113'00'20" . C5 1 27'28'19" 48.95C6 75 97'51'49" 189.97 249.61 N 67'29'00" W �i n 2 S88'4l'OO'W GRAVEL PAD CD ^N I,, z 54p. In 4 0 D v m \ •�'• DRNNAGE WAY :IE \�� \ \ N 6V34'i0' W/ 0 D J •B, 20' ELECTRIC EASEMENT <c1 1 f \\ \ IC SEPTTPIPES 4 \\ \ SE IC / 11'].54 \\ /y a� /o � Js 2-SrORY MASONRY BLOCK/ W000 -FRAME HOUSE (SEE DETAIL) (I 152.93 Z m a O £ \ GRAVEL DRIVEWAY GO 0 /\ 3 DRAINAGE N 89'58'30" E 435.01 �I CHUGACH STATE PARK 52'26'02' W 103.]1 i'x2' CONCI 2ND STORY Vx HOUSE DETAIL SURVEYOR'S CERTIFICATION I, Dee FLgh. a Registered Profead-d Leod Surveyor, do hereby eertUy that auney of the oproperty deacrlbed hereon has bean ppeerformed b7 me r mder m7 di -.t MperviMon: d Ibet ezisUvg Improvameab visible et thne of tbie —T ere shown h¢eon. IL V the oapovslbWty at the ower to QeteraUae the e�atevo f my eesemmta, eovenenIs. or rcatricUom. Und¢ vo ircum t-- should my dela h¢eov be ad for comtrocUou or for aateblishivg fence or bounds Unna. �p,�F, OFACAs � ¢� i�yi� {1 • T "'� i .... 'E ve„” r �i^ a1i t•4•., Ls-ssef 44'; LSSLtUL�.� D—: 9 _3_ 19 60 0 60 120 180 1 1 1 1 1 1 I I I Did—. are shown iv feel �I